Individual provider Active NPI

Carl Walter Fieser Jr., M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
National Provider Identifier
1346515319
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A96870 Issued in CA
Practice address
450 N Wiget LN
Walnut Creek, CA 94598-2408
Phone
(925) 691-9806
Fax
(925) 691-9807
NPI assigned
Mar 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A96870 CA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A96870 CA Primary

Addresses

Primary practice location

450 N Wiget LN
Walnut Creek, CA 94598-2408

Mailing address

450 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 691-9806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000369 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7911156070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Kansas School of Med (KC/Wich/Sal), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

1144 Sonoma Ave
Suite 105
Santa Rosa, CA 95405-4812
Phone (707) 202-5606

15047 Los Gatos Blvd
Suite 200
Los Gatos, CA 95032-2054
Phone (408) 364-6799

1524 McHenry Ave
Suite 445
Modesto, CA 95350-4573
Phone (209) 571-1693

2509 W March LN
Suite 250
Stockton, CA 95207-8222
Phone (209) 222-6061

450 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 482-8151

454 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 482-8111

4820 Business Ctr Dr
Suite 220
Fairfield, CA 94534-1696
Phone (510) 278-2700

650 University Ave
Suite 100
Sacramento, CA 95825-6726
Phone (916) 333-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96870CAMDMarriage & Family Therapist
A96870CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. Pain Medicine CurrentSince Sep 13, 2012 Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

4530 Balfour Rd
Brentwood, CA 94513
Phone 9256919806151

4530 Balfour Rd
Ste E
Brentwood, CA 94513

2923 Webster St
Ste 202
Oakland, CA 94609
Phone (510) 451-4142

999 N Tustin Ave
Ste 201
Santa Ana, CA 92705
Phone (714) 975-7950

1144 Sonoma Ave
Ste 105
Santa Rosa, CA 95405
Phone (707) 202-5606

2509 W March Ln
Ste 250
Stockton, CA 95207
Phone (209) 222-6061

450 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 413-4960

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1346515319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-691-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-691-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIESER",
        "first_name": "CARL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A96870",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A96870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.